Pro- to Anti-angiogenic Ratio in Preeclampsia

Background: During fetal development, human placenta undergoes both angiogenesis and vasculogenesis. An imbalance in proangiogenic [placental growth factor (PlGF) and vascular endothelial growth factor] and antiangiogenic factors [soluble fms like tyrosine kinase-1 (sFlt-1), soluble endoglin (sEng)] seems to play an important role in the pathophysiology of preeclampsia. Heme oxygenase-1 HO-1 is induced by ROS (reactive oxygen species) and NO (nitric oxide) and was recently discovered to be involved in angiogenesis. Methods: Hence, the present study was designed to analyze the proangiogenic and antiangiogenic role of heme oxygenase-1 and endoglin in maternal and cord blood of normotensive and preeclamptic women. Fifty pregnant women were selected and grouped as group 1 (control, n=25) comprising of normotensive women immediately after delivery; group 2 (study group) comprising of age -and sex-matched preeclamptic women. Study samples were drawn (maternal venous blood and umbilical cord blood) and heme oxygenase-1 and endoglin levels were analyzed by competitive enzymelinked immunosorbent assay. Results: Maternal and cord blood heme oxygenase-1 levels were significantly elevated in preeclamptic mothers as compared to normotensive pregnant women (p<0.001). Serum and cord blood endoglin levels were significantly lower in preeclamptic women as compared to normotensive pregnant women (p<0.001). HO-1/Eng ratio was drastically doubled in preeclamptics as compared to normotensive pregnant women. In normotensive [HO]/ [Eng+ IGF] were lower in normotensive pregnant and drastically increased in preeclamptics. Conclusion: The findings of a present study indicating a shift towards antiangiogenic profile in women with preeclampsia confirm their possible role to induce characteristic clinical manifestations of preeclampsia such as proteinuria and hypertension.